The Naked Prosthesis

A prosthesis is an expensive investment. To protect it, people with limb loss can have a cosmesis made of polyurethane or polyethylene foam and custom latex prosthetic skin that matches the users’ skin tone.

The life-like cosmesis allows a person with limb loss to blend into the four-limbed world and does protect the components of a prosthesis. But the disadvantages of cosmeses, including cost, weight and hampered prosthetic function, cause some amputees to rethink using a cosmetic cover. Other considerations, such as promoting awareness of the limb-loss community and greater self-expression, come into play as well.

North Dakotan Scott Moltzan, who lost his right leg above the knee in a snowmobile accident 13 years ago, initially wore a cosmesis.

“I used to cover my leg at first,” he says, “I think because of the emotional part of it. We tried to make it look like a real leg. I think that is very emotional, and I did have a cover for the first years.” But cost, weight and the limiting nature of the cosmesis ultimately swayed Scott to do without a cover. He says the cover was somewhat restrictive, making a difference in optimal function of his knee. Additionally, the cover would tear, requiring replacement. And most importantly, it added weight to the prosthesis.

“The key is, the less weight on the leg, the better,” Scott explains. “It gives you more flexibility and mobility. You feel a little bit freer.” What’s more, Scott decided the bare prosthesis was attractive. “I finally said, ‘Look, I have this prosthesis, and it’s metal, and it looks pretty cool,” he says. “So I’m proud of the technology, and on top of that, the leg looks great. It’s black and silver – it looks kind of European. I just use the little protector the knee comes with. That’s all I have on it.”

People Scott encounters seem accepting of his look – something he attributes to the frequent images of military veterans with computerized prostheses in the news media.

“I’ll just be walking along and people say to me, ‘Hey, that’s one of those computerized knees!’” Scott explains. “Then the next question is, ‘Were you in the military?’ I wasn’t in the military, but the military and the media coverage in general over the last 10 or 12 years has gotten a lot of exposure for amputees. People are more aware of them now – they are impressed with the technology, and want to learn about it.”

Aaron Holm, 43, of Minnesota, lost both legs above the knee in January 2007. A car traveling on the shoulder of a highway struck him while he was changing a flat tire. Aaron wears a carbon-gray protective cover on the componentry of his computerized legs, but says nothing he wears is an attempt to disguise them.

“I wouldn’t consider it a cosmetic cover that tries to cover something up,” says Aaron. “It’s out there, and if I’m walking down a street or sidewalk, you know I have prosthetic legs.”

Aaron says he never wanted flesh-tone prosthetic coverings. “When I originally picked my legs up at my practitioner’s place, he had put the skin-tone covers on them, and I said, ‘We’re taking these off. There’s nothing to hide,’” says Aaron.

Acceptance of his new reality as an amputee and a desire to focus on the future were factors in Aaron’s decision to go without cosmeses. So, too, were his children.

“I have three kids that are very active: hockey, dance, figure skating and hockey, hockey, hockey,” jokes Aaron. “I recognized very quickly, kids can be cruel later in life, so the more that the kids that surround my children look at this as something that is not out of the ordinary, the better.”

Photo courtesy of Aaron Holm

At first, when Aaron attended his children’s sports functions with his bare prostheses, the other kids were curious, but by the third or fourth time, he says they didn’t bat an eye. Additionally, it gave his children an opportunity to connect with his artificial limbs.

“My son was a little apprehensive at first, but then he started being the guy who was answering questions,” Aaron explains. “He was saying, ‘Those are prosthetic legs; my dad got hit by a car. You can touch this or look at this,’ and he’d lift up my leg and show them the hydraulic. So now he’s interacting too.”

Aaron also likes the unfettered feeling of going without covers. “I wear shorts as much as possible,” he says. “I like the feeling of freedom when you are wearing prostheses with shorts and the knees are bending. I don’t wear jeans to cover them up. I’d wear shorts every day if I could.”

Like Scott Moltzan, Aaron is often asked if he was in the military. But he remains unaffected by whatever responses his naked prostheses garner. “Other people’s reactions make no difference to me whatsoever,” he says. “Many people ask me if I was in the military. So some people do approach you and ask you questions, but it really doesn’t bother me. If people are curious, I’d much rather they ask me about it.”

Aaron has started a nonprofit foundation, wiggleyourtoes.org, dedicated to helping amputees in their recovery efforts – and his exposed prostheses have already inspired some new amputees. “I’m a bilateral above-knee, so when someone is looking at a below-knee unilateral amputation a few inches above their ankle and they see someone like me walk in in my shorts, the reaction is, ‘I guess I’m going to be OK,’ you know? It provides a lot of inspiration to people that it’s not over.”

Whether attributable to frequent images of military personnel with their high-tech prostheses on news channels, heightened visibility of amputee athletes with their sleek, unadorned sports prostheses or more amputees among the general population electing to go without cosmetic covers, the uncovered prosthesis seems to be gaining greater recognition. And that can only be a good thing for the limb-loss community.

This Web site was supported, in part, by grant number 90LL0002-03-00 and 90LL0002-03-01, from the Administration for Community Living, U.S. Department of Health and Human Services, Washington, D.C. 20201. Grantees undertaking projects under government sponsorship are encouraged to express freely their findings and conclusions. Points of view or opinions do not, therefore, necessarily represent official Administration for Community Living policy.